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Core values: In nursing, core nursing values include human dignity, integrity, autonomy,
altruism, and social justice.
Core disciplinary knowledge: The intellectual structures within which the discipline delineates
its unique focus of vision and social mandate. AACN has identified core disciplinary knowledge
as having three components: historic and philosophic foundations to the development of
nursing knowledge; existing and evolving substantive nursing knowledge; and methods and
processes of theory/knowledge development (AACN, 2002, p. 289).
Cost effectiveness: A way to examine both the costs and health outcomes of one or more
interventions; it compares one intervention to another (or the status quo) by estimating how
much it costs to gain a unit of a health outcome, like a life year gained or a death prevented.
Critical thinking: The skill of using logic and reasoning to identify the strengths and weaknesses
of alternative healthcare solutions, conclusions, or approaches to clinical or practice problems.
Cultural awareness: The deliberate self-examination and in-depth exploration of one’s biases,
stereotypes, prejudices, assumptions, and “isms” that one holds regarding individuals and
groups who are different from them (Campinha-Bacote, 1998).
Cultural competence: The ability to effectively work within the client’s cultural context.
Structural competence is recognition of the economic and political conditions that produce
health inequalities in the first place. It is the ability to understand how institutions, markets,
or healthcare delivery systems shape symptom presentations and to mobilize for correction of
health and wealth inequalities in society (Drevdahl, 2018; Metzl et al., 2018; Metzl et al., 2020).
Cultural and linguistic competence: A set of congruent behaviors, attitudes, and policies that
come together in a system, agency, or among professionals that enables effective work in
cross-cultural situations. ‘Culture’ refers to integrated patterns of human behavior that include
the language, thoughts, communications, actions, customs, beliefs, values, and institutions of
racial, ethnic, religious, or social groups. ‘Competence’ implies having the capacity to function
effectively as an individual and an organization within the context of the cultural beliefs,
behaviors, and needs presented by consumers and their communities (Cross et al., 1989).
Cultural competence is a developmental process that evolves over an extended period.
Culturally sensitive: “The ability to be appropriately responsive to the attitudes, feelings,
or circumstances of groups of people that share a common and distinctive racial, national,
religious, linguistic, or cultural heritage” (DHHS, OMH, 2001, p. 131).
Cultural humility: A lifelong process of self-reflection and self-critique whereby the individual
not only learns about another’s culture, but also examines her/his own beliefs and cultural
identities.
Determinants of health: The range of personal, social, economic, and environmental
factors that interrelate to determine individual and population health. These factors include
policymaking, social factors, health services, individual behaviors, and biology and genetics.
Determinants of health reach beyond the boundaries of traditional health care and public
health sectors. Sectors such as education, housing, transportation, agriculture, and environment
can be important allies in improving population health (Healthy People 2020).

THE ESSENTIALS: CORE COMPETENCIES FOR PROFESSIONAL NURSING EDUCATION 57